Approximately in the middle of the article is a statement referenced by the Arizona Chamber Foundation that states that there is a “hidden health care tax” which in essence is the increased premiums paid by businesses and consumers to cover rising healthcare costs absorbed by their insurance companies. The article goes further to add that the rising cost is due to un-insured patients being unable to pay for services at hospital or healthcare facilities. These facilities then pass these losses on to the consumer or the consumer’s insurance company.

In a “normal” business model this would sound like, and most likely be, a reasonable and logical process. The “healthcare” business model is unfortunately not even close to a “normal” business model. In the healthcare industry we have the government and insurance industries fingers controlling this model. If we want to be in or use the healthcare business, we play by their rules not our own.

Most healthcare providers will tell you that they have seen significant decreases in insurance reimbursements over the last few years. Most insured patients will tell you they are paying more out of pocket for services while noticing increased premiums.

With just two questions, I can show exactly why the uninsured do NOT effect insurance premiums, and therefore are NOT the cause of the insured’s increasing out of pocket costs.

Question 1: If I bill an insurance 20% more to make up for my losses from the non paying patients ( by the way, sometimes the insurance is the non-payer) with the insurance company pay the additional 20 %?

The answer is N0, because it would be more than their allowable fee.

Question 2: If I bill an insurance company for reimbursement for an un-insured patient, will they pay anything?

The answer, No, because the patient does not pay for that benefit. If I billed under another insured, that would be fraud and I would be in serious trouble.

It is the facility or provider that gets financially hurt, not the insurance industry. It is the insurance agency that benefits from the rate increases, not the provider.

While I agree insurance should be more affordable and available to everyone, the high cost of health care is more the creation of our own government requirements ( such as safety and privacy requirements as well as “turf war” laws created to restrict competitiveness in healthcare) and the insurance industry creating illusionary benefit cost increases to justify the rate increases.

One last question to think about:

What did people do when there was no such thing as health insurance and no government controlling agencies such as FDA, OSHA, HIPPA, AHRQ, HHS, and others? Additionally, what did they do prior to 1938 when no prescription laws or patented pharmaceutical drugs were created? What competitive choices did the consumer have before laws were created to restrict the scope of practice for many providers while allowing an unlimited scope only to a couple of provider types?

I am not suggestion that the laws and agencies are unnecessary, however, I am suggesting that they were used in a way to create a large portion of the high costs and low quality of healthcare – not the uninsured!!!

Before we can create better quality and affordable health care, we need to look deeper into what has caused the lesser quality high cost of health care we have now!

The biggest reason I believe the new health care reform will not improve our healthcare system is because we failed to first address these very important questions. I think this is because healthcare affordability and quality was never the primary purpose when creating the reform laws we are calling, Obamacare.

Sincerely,

Dr. Bruce B. Lee, D.C., MUA-C

Fairfield Inn Flagstaff
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Flagstaff, AZ 86001 USA
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